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Are Psychiatric Institutions/Asylums a Necessity?

When most of us think of asylums, we think of Halloween horror movies and terrorizing people. However, recently a case was made by Dominic Sisti, the director of the ScattergoodEthics Program and assistant professor of medical ethics at the Perelman School of Medicine at the University of Pennsylvania, that there is a need for ethically administrated asylums for individuals who struggle with mental illness. Many prisons and jails in the United States house inmates with serious mental illnesses and hospitals house these individuals for months and even longer. Hospital stays for the mentally ill are designed to stabilize patients and then release them back into society. However, their illness may not be headed toward long-term recovery upon discharge.

Bringing back psychiatric asylums could provide sanctuary and safety for those who truly need it. In this type of a setting, the mentally ill could stabilize and even recover from the illnesses they are struggling with. Our current systems, Sisti indicates, often fail to, “protect and care for individuals who have serious mental illness in the appropriate place and at the appropriate time. Mental health treatment should be provided in a seamless continuum that ranges from outpatient care, to community services and supportive housing, to inpatient medical care. But the system is so utterly disjointed, uncoordinated and poorly funded, that those who need help, instead end up in jails and prisons, or warehoused in nursing homes and other group housing facilities.” (

Because of the history of abuse and neglect, most individuals continue to believe that asylums are harmful, dangerous, and gothic type evil places. There are a few public and private institutions but the waitlists are lengthy and care is expensive.

Sisti points out that in mental health care, individuals often find themselves in hospitals, jails, and prisons, only to be sent on their way with minimal coping skills and or medications until they show up again. Modern asylums could provide much more stability and hope for the mentally ill. Sisti argues that the cost of these programs should be part of the broader health care system and that the quality and costs should be very visible and forthright. These facilities could provide the safe haven that the mentally ill seek. Instead of investing so many millions in housing the mentally ill in prisons or hospitals and discharging them without proper care or treatment, it would make much more sense to provide better well-functioning safe asylums for the mentally ill.